Can EVAR Replace Open Repair as Primary Treatment for Abdominal Aortic Aneurysm? - EVAR versus open repair in AAA

Miju Bae, Sung Woon Chung, Chung Won Lee, Up Huh, Eunji Kim, Chang Won Kim

Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University College of Medicine, Busan, Korea

Background : With significant reduction in the number of open aneurysm repairs, endovascular aneurysm repair (EVAR) has dramatically transformed the management of abdominal aortic aneurysm (AAA). This paper compares the demographics, operative data, complications, and mortalities associated with AAA after treatment with open repair and EVAR.

Methods : A retrospective review was performed on 136 patients with AAA who were treated with either open repair or EVAR over a period of eight years.

Results : Mean age in the EVAR group was higher than that in the open repair group (p = 0.001). Hospital mortality showed no significant difference between the groups (p = 0.360). However, the overall survival rate was significantly lower in the EVAR group (p = 0.033). In 21 cases of ruptured AAA, two patients underwent EVAR and 19 patients underwent open repair. The two patients who underwent EVAR are still alive (follow-up duration, 49 months and 24 months). Mortality rate associated with open repair in ruptured AAA was 52.6%.

Conclusion : It would be ideal to set stricter criteria for EVAR, particularly for younger patients. EVAR seems to be more advantageous in cases of emergency ruptured AAA rather than as an elective procedure.

책임저자: Sung Woon Chung

Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University College of Medicine, Busan, Korea

발표자: Chung Won Lee, E-mail : vasculardoctorlee@gmail.com